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1.
Climacteric ; 26(2): 75-79, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36690015

RESUMO

Divergent opinions have been reported in the literature regarding the influence of the climacteric on the prevalence, incidence and types of urinary incontinence. In addition, the influence of hormonal therapy in the climacteric (HRT) on the occurrence of urinary incontinence in the perimenopausal period has been the subject of much discussion. This review evaluates the current literature regarding any possible association between the climacteric and the prevalence, incidence and types of urinary incontinence as well as illustrating the possible influence of HRT on urinary incontinence. Urinary incontinence is more common in women than in men and there is evidence to suggest that the prevalence of urinary incontinence in women increases in a linear fashion with age. There is no conclusive evidence to support a specific increase in the prevalence of urinary incontinence at the time of the menopause. Stress urinary incontinence is more common in premenopausal women and urgency urinary incontinence and mixed incontinence are more common in postmenopausal women. Women receiving systemic estrogen, with or without progestogen, are more likely to develop or experience worsening of incontinence.


Assuntos
Climatério , Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Humanos , Prevalência , Incidência , Menopausa , Incontinência Urinária/epidemiologia , Incontinência Urinária por Estresse/epidemiologia
2.
Climacteric ; 22(3): 217-222, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30572737

RESUMO

The reported prevalence of urinary incontinence (UI) among women varies widely in different studies due to the use of different definitions, the heterogenicity of different study populations, and population sampling procedures. Population studies from numerous countries have reported that the prevalence of UI ranged from approximately 5% to 70%, with most studies reporting a prevalence of any UI in the range of 25-45%. Prevalence figures increase with increasing age, and in women aged ≥70 years more than 40% of the female population is affected. Prevalence rates are even higher in the elderly-elderly and amongst nursing home patients. There are only a few studies describing progression as well as remission of UI in the general population as well as in selected groups of the population. The mean annual incidence of UI has been reported to range from 1% to 9%, while estimates of remission are more varying, from 4% to 30%. The prevalence of UI is strongly related to the age of the woman and thus, due to the increase in mean life expectancy, the overall prevalence of UI in women is expected to increase in the future.


Assuntos
Incontinência Urinária/epidemiologia , Fatores Etários , Idoso , Feminino , Humanos , Incidência , Prevalência , Incontinência Urinária/etiologia
4.
Int J Clin Pract ; 69(12): 1508-16, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26351086

RESUMO

OBJECTIVE: To evaluate the risk factors and comorbidities associated with nocturia in men and women aged ≥ 40 years. MATERIAL AND METHODS: The EpiLUTS study was an Internet-based cross-sectional, population-representative survey involving 30,000 men and women from the USA, UK and Sweden evaluating lower urinary tract symptoms (LUTS) using the LUTS Tool. A secondary analysis of the EpiLUTS data using participants with nocturia was performed. Descriptive statistics were used to examine the data. Logistic regressions were used to analyse associations of comorbid conditions and risk factors in men and women with nocturia ≥ 2. RESULTS: With a 59% response rate, nocturia ≥ 1 was quite common at 69% in men and 76% in women; 28% men and 34% women had nocturia ≥ 2. Age, body mass index (in women), Hispanic and Black responders, diabetes, high blood pressure, anxiety and depression and a history of bed-wetting were significantly associated with nocturia ≥ 2. Arthritis, asthma, diabetes, heart disease, inflammatory bowel disease, bladder infection, uterine prolapse, hysterectomy and menopausal status were all significantly associated with nocturia ≥ 2 in women. Prostatitis and prostate cancer were significant in men with nocturia ≥ 2. British and Swedish participants had a lesser risk of nocturia ≥ 2. CONCLUSION: Nocturia is a highly prevalent condition associated with various risk factors and comorbidities. Treatment of nocturia should be aimed at these causes in a multidisciplinary fashion. Further studies are needed to look specifically at these conditions in the pathophysiology of nocturia.


Assuntos
Noctúria/etiologia , Adulto , Idoso , Comorbidade , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior , Masculino , Pessoa de Meia-Idade , Noctúria/epidemiologia , Prevalência , Qualidade de Vida , Fatores de Risco , Suécia/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
5.
Int J Clin Pract ; 69(2): 199-217, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25495905

RESUMO

OBJECTIVES: To conduct a systematic review to determine whether there is an association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) or overactive bladder (OAB) in women. METHODS: We systematically reviewed English language observational studies on the effect of MetS (or component factors) on the presence of OAB or LUTS in women. We searched PubMed, Web of Science and The Cochrane Library with no date restrictions, checked reference lists and undertook citation searches in PubMed and Google Scholar. Studies were assessed for risk of bias. Because of heterogeneity, results were not pooled, but are reported narratively. RESULTS: Of 27 included studies, only three looked at the link between MetS and OAB. The rest looked at links between OAB and components of MetS such as obesity or insulin resistance (n = 10), between MetS and urinary symptoms (n = 3) and between urinary symptoms and components of MetS, such as obesity (n = 14). Evidence is currently limited, but it does suggest that there may be important links between MetS and OAB and components of MetS such as obesity. CONCLUSIONS: The literature on MetS and OAB or LUTS in women is limited, and poor quality. However, the evidence available on obesity appears to support MetS as a contributor and predictor of LUTS in women. Many of the women with LUTS will be overweight and will have features of the MetS, if looked for. This provides not only an opportunity to encourage weight loss as an adjunct to therapy for the OAB symptoms but also a window of opportunity to address cardiovascular risk factors and prevent future cardiovascular morbidity and mortality.


Assuntos
Síndrome Metabólica/complicações , Índice de Gravidade de Doença , Bexiga Urinária Hiperativa/complicações , Doenças Cardiovasculares/complicações , Feminino , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/mortalidade , Síndrome Metabólica/mortalidade , Prevalência , Fatores de Risco , Bexiga Urinária Hiperativa/mortalidade
8.
Int J Clin Pract ; 68(8): 972-85, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24703195

RESUMO

AIMS: To evaluate the safety and tolerability of the ß3 -adrenoceptor agonist, mirabegron, in patients with overactive bladder (OAB). METHODS: Tolerability and safety data from three 12-week, randomised, placebo-controlled, double-blind, Phase III trials (Studies 046, 047 and 074) were pooled by treatment group. The three studies were of a similar design, although the assessed doses of mirabegron [25, 50 or 100 mg once daily (qd)] varied, and tolterodine extended release (ER) 4 mg was included as an active-control arm in Study 046 only. Tolerability and safety data from a 1-year, randomised, double-blind, Phase III trial (Study 049) are also presented. Safety variables included the incidence and severity of treatment-emergent adverse events (TEAEs), vital signs and electrocardiogram data. RESULTS: Mirabegron (25, 50 or 100 mg qd) was safe and well-tolerated in patients with OAB over 12-week (n = 2736) and 1-year (n = 1632) periods. The incidence of TEAEs and treatment discontinuations as a result of TEAEs was low; the majority were mild in severity and few were serious. Hypertension, nasopharyngitis and urinary tract infection were the most common TEAEs with mirabegron. The mirabegron tolerability profile was similar to that seen with placebo and tolterodine ER 4 mg, except for dry mouth, which occurred, on average, five times less frequently with mirabegron than tolterodine ER 4 mg. In the pooled 12-week analysis, mirabegron 50 mg was associated with placebo-adjusted mean increases of 0.4-0.6 mmHg in blood pressure and approximately one beat per minute in pulse rate, both reversible upon treatment discontinuation. The incidence of Major Adverse Cardiovascular Events as adjudicated by an independent cardiovascular committee was low and similar across treatment groups. CONCLUSION: The favourable tolerability profile of mirabegron in patients with OAB may allow improved treatment compliance compared with antimuscarinics, with important implications for patient outcomes.


Assuntos
Acetanilidas/farmacologia , Antagonistas de Receptores Adrenérgicos beta 3/farmacologia , Tolerância a Medicamentos , Uso Off-Label , Tiazóis/farmacologia , Resultado do Tratamento , Bexiga Urinária Hiperativa/tratamento farmacológico , Agentes Urológicos/administração & dosagem , Acetanilidas/uso terapêutico , Adolescente , Antagonistas de Receptores Adrenérgicos beta 3/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Estudos Prospectivos , Tiazóis/uso terapêutico , Agentes Urológicos/efeitos adversos
9.
Int J Clin Pract ; 68(3): 356-62, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24373133

RESUMO

BACKGROUND: The Overactive Bladder Syndrome (OAB) and the Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) are different urological conditions sharing 'urgency' as a common symptom. The aim of this review is to address our existing knowledge and establish how these symptoms are interrelated and to determine whether or not there is a common link between both symptoms complexes that help to distinguish one from the other. METHODS: Pubmed was used to obtain references for this non-systematic review aiming to discuss differences between OAB and BPS/IC. Guidelines of several professional associations and discussions based on expert opinion from the authors were implemented. RESULTS: Whilst in BPS the hallmark symptom is pain on bladder filling, urgency is the defining symptom of OAB. Whilst it is likely that the pain in BPS/IC arises from local inflammation in the bladder wall, the nature of urgency as a symptom, its origin, and the relationship between urgency and pain, as well as the different afferent mechanisms associated with the genesis of these sensory symptoms, remains unknown. Although the aetiology of both OAB and PBS/IC is unclear, the influence of environmental factors has been suggested. Both are chronic conditions with very variable symptom resolution and response to therapy. The relationship with voiding dysfunction, gynaecological causes of chronic pelvic pain or the possible alteration of the hypothalamic-pituitary-adrenal axis and psychological disorders has not been established. Inflammation has been suggested as the common link between OAB and BPS/IC. CONCLUSIONS: OAB and BPS/IC are different symptoms complexes that share urgency as a common symptom. None of them have a specific symptom although pain on bladder filling is the hallmark symptom in BPS/IC. Bladder pain with urgency should be a trigger for referral to the provider with appropriate knowledge and expertise in this disease state, whereas the management of OAB should be part of normal routine care in the community.


Assuntos
Cistite Intersticial/etiologia , Bexiga Urinária Hiperativa/etiologia , Incontinência Urinária de Urgência/etiologia , Progressão da Doença , Meio Ambiente , Feminino , Predisposição Genética para Doença/genética , Doenças dos Genitais Femininos/complicações , Humanos , Medição da Dor , Delitos Sexuais , Obstrução do Colo da Bexiga Urinária/etiologia
10.
Int J Clin Pract ; 67(10): 1015-33, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24073974

RESUMO

AIMS: Studies on the burden and comorbidities associated with urgency urinary incontinence (UUI) are difficult to compare, partly because of the evolution of definitions for lower urinary tract symptoms and the various instruments used to assess health-related quality of life (HRQL). This article summarises published evidence on comorbidities and the personal burden associated specifically with UUI to provide clinicians with a clear perspective on the impact of UUI on patients. METHODS: A PubMed search was conducted using the terms: (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR quality of life OR well-being OR depression OR mental health OR sexual health OR comorbid), with limits for English-language articles published between 1991 and 2011. RESULTS: Of 1364 identified articles, data from 70 retained articles indicate that UUI is a bothersome condition that has a marked negative impact on HRQL, with the severity of UUI a predictor of HRQL. UUI is significantly associated with falls in elderly individuals, depression, urinary tract infections, increased body mass index, diabetes and deaths. The burden of UUI appears to be greater than that of stress urinary incontinence or overactive bladder symptoms without UUI. UUI adversely impacts physical and mental health, sexual function and work productivity. CONCLUSIONS: UUI is associated with numerous comorbid conditions and inflicts a substantial personal burden on many aspects of patients' lives. Healthcare providers should discuss UUI with patients and be aware of the impact of UUI and its associated comorbidities on patients' lives.


Assuntos
Incontinência Urinária/complicações , Acidentes por Quedas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Efeitos Psicossociais da Doença , Depressão/etiologia , Complicações do Diabetes/complicações , Eficiência , Feminino , Fraturas Ósseas/etiologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Qualidade de Vida , Disfunções Sexuais Fisiológicas/etiologia , Incontinência Urinária/mortalidade , Incontinência Urinária/psicologia , Infecções Urinárias/etiologia , Adulto Jovem
14.
BJOG ; 120(12): 1548-55, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23786421

RESUMO

OBJECTIVE: To study the effect of one vaginal delivery (VD) compared with one caesarean section (CS) on the prevalence, severity and bothersomeness of urinary incontinence (UI) subtypes--stress (SUI), urge (UUI) and mixed (MUI)--20 years after delivery. DESIGN: Registry-based national cohort study. SETTING: Women who returned postal questionnaires (response rate 65.2%) in 2008. POPULATION: Primiparae with one birth in 1985-88 (n = 5236) and no further births. METHODS: Medical Birth Register data were linked to a questionnaire. Analysis of variance and multivariate analysis were used to obtain adjusted prevalences and odds ratios (adjOR). MAIN OUTCOME MEASURES: Prevalence, risk factors, severity, bothersomeness of UI subtypes. RESULTS: The prevalence of SUI, UUI and MUI was 15.3, 6.1, 14.4%, respectively, and was higher for all subtypes after VD versus CS. Moderate to severe incontinence was more prevalent after VD (21.3%) compared with CS (13.5%; adjOR 1.68, 95% confidence interval [95% CI] 1.40-2.03). Bothersome incontinence differed between MUI (38.9%), UUI (27.1%) and SUI (18.0%). The prevalence of bothersome UI was higher after VD compared with CS (11.2 versus 6.3%; adjOR 1.85, 95% CI 1.42-2.39) and consulting a doctor for UI was reported more often after VD than CS. Bothersome MUI occurred in 40.0% of incontinent women after VD compared with 29.9% after CS (adjOR 1.65, 95% CI 1.07-2.54). Symptomatic pelvic organ prolapse was an important modifier of UI with regard to its prevalence, duration, type and bothersomeness. CONCLUSION: The prevalence of SUI, UUI and MUI was higher and moderate to severe UI and bothersome UI were reported more often after VD than CS 20 years after one delivery.


Assuntos
Parto Obstétrico/efeitos adversos , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Índice de Massa Corporal , Cesárea/efeitos adversos , Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Paridade , Prolapso de Órgão Pélvico/epidemiologia , Gravidez , Prevalência , Suécia/epidemiologia , Fatores de Tempo , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária de Urgência/etiologia
15.
BJOG ; 120(2): 144-151, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22413831

RESUMO

OBJECTIVE: To investigate the prevalence and risk factors for urinary incontinence (UI) 20 years after one vaginal delivery or one caesarean section. DESIGN: Registry-based national cohort study. SETTING: Women who returned postal questionnaires (response rate 65.2%) in 2008. POPULATION: Singleton primiparae who delivered in the period 1985-1988 with no further births (n = 5236). METHODS: The Swedish Pregnancy, Obesity and Pelvic Floor (SWEPOP) study linked Medical Birth Register (MBR) data to a questionnaire about UI. MAIN OUTCOME MEASURES: Prevalence of UI and UI for more than 10 years (UI > 10 years) were assessed 20 years after childbirth. RESULTS: The prevalence of UI (40.3 versus 28.8%; OR 1.67; 95% CI 1.45-1.92) and UI > 10 years (10.1 versus 3.9%; OR 2.75; 95% CI 2.02-3.75) was higher in women after vaginal delivery than after caesarean section. There was no difference in the prevalence of UI or UI > 10 years after an acute caesarean section or an elective caesarean section. We found an 8% increased risk of UI per current body mass index (BMI) unit, and age at delivery increased the UI risk by 3% annually. CONCLUSIONS: Two decades after one birth, vaginal delivery was associated with a 67% increased risk of UI, and UI > 10 years increased by 275% compared with caesarean section. Our data indicate that it is necessary to perform eight or nine caesarean sections to avoid one case of UI. Weight control is an important prophylactic measure to reduce UI. Current BMI was the most important BMI-determinant for UI, which is important, as BMI is modifiable.


Assuntos
Cesárea , Parto , Incontinência Urinária/epidemiologia , Adulto , Índice de Massa Corporal , Estudos de Coortes , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Idade Materna , Pessoa de Meia-Idade , Paridade , Gravidez , Prevalência , Sistema de Registros , Fatores de Risco , Inquéritos e Questionários , Suécia/epidemiologia , Incontinência Urinária/etiologia
16.
BJOG ; 120(2): 152-160, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23121158

RESUMO

OBJECTIVE: To investigate prevalence and risk factors for symptomatic pelvic organ prolapse (sPOP) and sPOP concomitant with urinary incontinence (UI) in women 20 years after one vaginal delivery or one caesarean delivery. DESIGN: Registry-based national cohort study. SETTING: Women who returned a postal questionnaire in 2008 (response rate 65.2%). POPULATION: Singleton primiparae with a birth in 1985-88 and no further births (n = 5236). METHODS: The SWEPOP study used validated questionnaires about sPOP and UI. MAIN OUTCOME MEASURES: Prevalence rate and risk of sPOP with or without concomitant UI. RESULTS: Prevalence of sPOP was higher after vaginal delivery compared with caesarean section (14.6 versus 6.3%, odds ratio [OR] 2.55; 95% confidence interval [95% CI] 1.98-3.28) but was not increased after acute compared with elective caesarean section. Episiotomy, vacuum extraction and second-degree or more laceration were not associated with increased risk of sPOP compared with spontaneous vaginal delivery. Symptomatic POP increased 3% (OR 1.03; 95% CI 1.01-1.05) with each unit increase of current BMI and by 3% (OR 1.03; 95% CI 1.02-1.05) for each 100 g increase of infant birthweight. Mothers ≤ 160 cm who delivered a child with birthweight ≥ 4000 g had a doubled prevalence of sPOP compared with short mothers who delivered an infant weighing < 4000 g (24.2 versus 13.4%, OR 2.06; 95% CI 1.19-3.55). Women with sPOP had UI and UI > 10 years more often than women without prolapse. CONCLUSION: The prevalence of sPOP was doubled after vaginal delivery compared with caesarean section, two decades after one birth. Infant birthweight and current BMI were risk factors for sPOP after vaginal delivery.


Assuntos
Cesárea , Parto , Prolapso de Órgão Pélvico/epidemiologia , Incontinência Urinária/epidemiologia , Adulto , Estudos de Coortes , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Paridade , Prolapso de Órgão Pélvico/etiologia , Gravidez , Prevalência , Sistema de Registros , Fatores de Risco , Inquéritos e Questionários , Suécia/epidemiologia , Incontinência Urinária/etiologia
17.
BJOG ; 118(7): 806-13, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21401855

RESUMO

OBJECTIVES: To assess the effect of coffee and tea consumption on symptoms of urinary incontinence. DESIGN: Population-based study. SETTING: The Swedish Twin Register. POPULATION: In 2005, all twins born between 1959 and 1985 in Sweden (n = 42,852) were invited to participate in a web-based survey to screen for common complex diseases and common exposures. The present study was limited to female twins with information about at least one urinary symptoms and coffee and tea consumption (n = 14,031). MAIN OUTCOME MEASURE: The association between coffee and tea consumption and urinary incontinence, as well as nocturia, was estimated as odds ratios (ORs) with 95% confidence intervals. RESULTS: Women with a high coffee intake were at lower risk of any urinary incontinence (OR 0.78, 95% CI 0.64-0.98) compared with women not drinking coffee. Coffee intake and incontinence subtypes showed no significant associations whereas high tea consumption was specifically associated with a risk for overactive bladder (OR 1.34, 95% CI 11.07-1.67) and nocturia (OR 1.18, 95% CI 1.01-1.38). Results from co-twin control analysis suggested that the associations observed in logistic regression were mainly the result of familial effects. CONCLUSIONS: This study suggests that coffee and tea consumption has a limited effect on urinary incontinence symptoms. Familial and genetic effects may have confounded the associations observed in previous studies.


Assuntos
Café , Chá/efeitos adversos , Bexiga Urinária Hiperativa/induzido quimicamente , Incontinência Urinária/induzido quimicamente , Adulto , Café/efeitos adversos , Intervalos de Confiança , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Noctúria/induzido quimicamente , Razão de Chances , Sistema de Registros , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Inquéritos e Questionários , Suécia
18.
Neurourol Urodyn ; 29(1): 30-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20025017

RESUMO

AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse? *What is the possible pathophysiology of OAB in POP? *Do OAB symptoms and DO change after conservative or surgical treatment of POP? METHODS: We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery. RESULTS: Community- and hospital-based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role. CONCLUSIONS: There are strong indications that there is a causal relationship between OAB and POP.


Assuntos
Diafragma da Pelve/fisiopatologia , Prolapso de Órgão Pélvico/complicações , Obstrução do Colo da Bexiga Urinária/etiologia , Bexiga Urinária Hiperativa/etiologia , Bexiga Urinária/fisiopatologia , Feminino , Humanos , Prolapso de Órgão Pélvico/epidemiologia , Prolapso de Órgão Pélvico/fisiopatologia , Prolapso de Órgão Pélvico/terapia , Pessários , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/epidemiologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Obstrução do Colo da Bexiga Urinária/terapia , Bexiga Urinária Hiperativa/epidemiologia , Bexiga Urinária Hiperativa/fisiopatologia , Bexiga Urinária Hiperativa/terapia , Procedimentos Cirúrgicos Urogenitais
20.
Int J Clin Pract ; 62(10): 1588-93, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18822029

RESUMO

Guidelines for the management of continence and overactive bladder are generally available across Europe. For a majority of countries, these have been adopted by professional societies in either urology or gynaecology for local use. There has, however, been little monitoring of formal implementation of these guidelines and seldom any attempt to audit their operation. The state of continence care therefore remains largely unknown. This article reviews current guidelines and their status across Europe and examines what might be relevant from other disease areas to promote successful implementation.


Assuntos
Guias de Prática Clínica como Assunto , Bexiga Urinária Hiperativa/terapia , Incontinência Urinária/terapia , Europa (Continente) , Fidelidade a Diretrizes , Implementação de Plano de Saúde , Humanos
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